HEALTH INSURANCE COSTS

One of the first questions many people ask about health insurance is “How much will this cost me?” The answer to this question is different for everyone, but there are certain costs that you can expect to pay.

What will you pay for health insurance?

The amount you pay for health insurance each month is called a premium. The amount you pay depends on the coverage you receive, the number of people covered and your plan’s deductible. Plan rates also vary based on your age, where you live and if you use tobacco. As long as you make your monthly payment, your insurance will remain active.

What is a deductible?

A health insurance deductible is the amount of money you must pay before your plan starts to help you pay your bills. If your plan has a $1,000 deductible, you must pay that much toward medical care before your insurance company begins paying for some of your costs.

Are there other costs I have to pay?

During the year, you will be asked to pay for some things yourself. Here’s a rundown of some costs you may have to pay.

Copayments

A payment you make at the doctor’s office, urgent care clinic, ER or the pharmacyExample: $25 copayment at the doctor’s office

Coinsurance

Your percentage of medical bills left after your provider pays their shareExample: 20 percent coinsurance for a hospital stay

Out-of-network or uncovered treatment

If you go to a doctor who’s not in the plan networkor if the type of treatment is not covered by the plan, you may have to pay a higher percentage of the costs (or the full cost of care)

There are limits to how much you spend

Recent laws put a cap on the amount of money you are expected to pay out of pocket each year. It’s called an out-of-pocketlimit or out-of-pocket max. Once you have reached this amount, your insurance provider must pay all of your covered costs for the rest of the year.

Choosing the right plan to keep costs low

Keeping your health insurance costs low is important for your budget. It is also important to choose a plan that offers the coverage you actually need.